CHICAGO — The suburban mom had done everything she could think of to help her 14-year-old daughter navigate the stormy waters of adolescence. She was alert, accessible and proactive, asking a million questions and calling in a professional counselor when the girl's behavior and appearance grew troubling.
And yet there she was, late one winter night in her Carol Stream, Ill., home, watching her daughter twist a scarf around her own neck and threaten to commit suicide on the spot.
"Do you really want to kill yourself?" the mom asked.
"I would do it right now if I knew I could do it completely," the girl shot back.
Teen suicide is a nightmare that descends upon American families more than 1,000 times a year.
Such deaths often leave communities with agonizing questions. How could such a thing happen? Were any warning signs missed? Could anyone have stepped in?
Pulling a young person back from the edge of suicide can be a complicated venture. The rescue of one suburban teen, described by the Carol Stream mother and daughter on the condition their names not be used, required dedicated parents, a vigilant friend, a supportive teacher, school officials, therapists and a fair amount of luck.
But if there is one lesson to absorb, the mom said, it is this: If you think this can't threaten your family, you're wrong.
"There are just certain things people close their eyes to, keep their mouths shut about," she said. "As a result, there are devastating consequences."
Growing up in Carol Stream, the girl was chatty and outgoing, an artist, athlete and proud straight-A student. But toward the end of middle school, her personality changed. She gradually withdrew from her family and friends, finding comfort in binge eating and endless Facebook correspondence. Though her parents encouraged her to resume her social life, she begged off, saying she was too busy with schoolwork.
"I didn't want to talk to anyone anymore," the girl said. "I was uninterested."
When she hit Glenbard North High School in 2008, the self-esteem she had built upon the rock of academic excellence started to erode. Getting A's wasn't good enough anymore — she had to be beyond perfect. That led to paralysis before homework assignments and tests, which led to poor grades and even more negative thoughts.
She grew lethargic, flopping into bed as soon as she got home and neglecting her hygiene. She screamed at her little sister. She screamed at her parents.
It might seem obvious in retrospect that she was suffering from depression, which hits about 5 percent of teens and is a major risk factor for suicide. But she kept her dark thoughts to herself, and she bluffed the counselors she saw for her eating disorder so they did not believe her condition was severe, her mother said.
Dr. Nancy Rappaport, an assistant professor of psychiatry at Harvard Medical School, said that is a common mistake.
"In the initial stages, it's possible to miss it," she said. Teens "may not present as depressed, but irritable. A parent can understandably think this is just moodiness. It can take them a little bit of time to figure out."
In January 2009, the girl had another terrible argument with her mother over something trivial neither can recall. She went into her bedroom, and what had been a vague thought started to crystallize.
"It somehow kind of formed: 'Oh, people (kill themselves). Maybe I could do it, too,' " the girl said. "I could be out of all this, and I wouldn't have to deal with it anymore. It would be done."
That night, she signed on to Facebook, and told a friend she was considering suicide.
Her friend tried to talk her out of it, telling her that lots of people cared about her. The girl ignored the pleas and signed off.
The friend, though, didn't keep it to herself. The next day at school, shortly after the girl carved a curse into her forearm in a spasm of self-loathing, she was called to the guidance office. There, in a meeting with her parents, a counselor and a psychologist, it was decided she would be placed in outpatient treatment.
That night brought the worst fight of all. The girl fell into a rage when her parents wouldn't let her out of their sight.
When she swore she would find a way to die and attempted to throttle herself again, their decision became clear. Just after midnight, her father had her admitted to the crisis stabilization unit at Central DuPage Hospital, in Winfield, Ill.
She was there for several weeks, the youngest patient by 10 years. She stayed in a room designed to minimize self-harm (the furnishings included a mirror made of plastic), attended group and individual therapy and learned things about depression.
"It's a chemical imbalance," she said. "It's not who I am. (The information) made me feel better. It was more of an assurance that I can get past this."
Her stay, though, was no magical turning point. She was unable to tolerate antidepressant medications, and once she left Central DuPage, she didn't get much out of her visits to a counselor.
She remained fragile upon her return to school about six weeks after her suicide threats. She knew that other students, seeing her arms wrapped in bandages, were whispering about her. She was far behind in her class work, facing the possibility of failure for the first time.
Her English teacher, Jim Rodgers, couldn't help noticing. The girl was one of his star students, a talented writer who sat in the front row and participated earnestly in discussions. When she went quiet, the entire class flagged.
From the start of the year, he had encouraged her writing. He had written a book, a self-help guide that reflected his recovery from a wrenching divorce, and he saw in her a kindred wordsmith.
On the last day of school, the girl handed him a note and left the room. Rodgers opened it to read this:
My freshman English teacher, Mr. Rodgers, is, without a doubt, the biggest inspiration in my life today ... He does not know how much he has affected my life. He has saved it.
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